The application and surgical technique of laparoscopic hepatectomy in living donor liver transplantation:A report of 12 cases

doi:10.19538/j.cjps.issn1005-2208.2017.05.24

Abstract：Objective To evaluate the application and surgical technique of laparoscopic hepatectomy in living donor liver transplantation (LDLT). Methods The clinical data of 12 cases of laparoscopic hepatectomy in LDLT performed from September 2015 to October 2016 in Department of Liver Surgery, Liver Transplantation Center, West China Hospital of Sichuan University were analyzed retrospectively. The surgical outcomes and short-term prognosis of the donors (12 cases) and recipients (12 cases) were analyzed. Results Among the 12 donors, right hemihepatectomy without middle hepatic vein was performed in 6 cases;left lateral lobectomy in 3 cases and left hemihepatectomy without middle hepatic vein in 3 cases. The median intraoperative blood loss was 400 mL (ranging from 100 to 600 mL). The median hospital stay of the donors was 7 days (ranging from 4 to 10 days). All donors had no postoperative complications and deaths. Among the 12 recipients, the median graft-recipient weight ratio (GRWR) was 0.94%(ranging from 0.54%to 3.70%). The median surgical duration was 625 min (ranging from 405 to 720 min). The median intraoperative blood loss of the recipients was 750 mL (ranging from 200 to 3000 mL). The median hospital stay of the donors was 20 days (ranging from 7 to 40 days). One case had gastrointestinal bleeding in postoperative day 7 and the bleeding stopped after conservative treatment. One case died from respiratory failure in postoperative day 8. The other recipients were discharged smoothly. Conclusion With the improved surgical techniques and advanced laparoscopic instruments, it is believed that laparoscopic LDLT is a feasible technique and has a promising prospect.